B.C.'s top doctors place fentanyl deaths in the context of prohibition

It is not safe to use street drugs in Metro Vancouver this summer. That’s the message from police following another rash of overdoses related to the synthetic opiate fentanyl.

And part of the reason for that is prohibition-style drug laws that keep illicit substances beyond the reach of regulations that could save lives, health authorities told the Georgia Straight.

In a telephone interview, Const. Brian Montague emphasized that a problem once confined to heroin addicts now concerns recreational drug users of every sort.

“These are teenagers, husbands, wives, and family people with jobs,” the Vancouver Police Department spokesperson said.

Montague explained that authorities are finding fentanyl, a drug anywhere from 50 to 100 times more toxic than morphine, mixed with and sold as cocaine, methamphetamine, and ecstasy, and in fake pharmaceuticals such as pills labelled as OxyContin.

Montague’s warning follows the August 3 death of Jack Bodie, a 17-year-old boy who was found unconscious in an East Vancouver park after he took fentanyl sold in the form of a green pill. Bodie died later in hospital, while a 16-year-old friend narrowly avoided the same fate. Before that, on July 31, a 31-year-old North Vancouver man died of another overdose in which fentanyl is suspected. And on July 20, a North Vancouver couple in their early 30s died in their home after taking fentanyl. They left behind a two-year-old son.

In discussing these deaths, some of the province’s top health officials told the Straight they are open to unconventional methods to manage drug-use risks. Going further, they placed deaths linked to fentanyl in the context of prohibition, saying that existing drug laws are at least partly responsible for avoidable fatalities.

“We are in a situation where these drugs are prohibited,” said B.C.’s top doctor, Perry Kendall. “It is not helping. People are still taking them.”

In a separate interview, Dr. Mark Lysyshyn, a medical health officer for Vancouver Coastal Health (VCH), suggested overdose deaths could be avoided if illicit drug sales could be raised from the shadows.

“This is definitely a problem that a legal, regulated drug market could solve,” he said. “A legal, regulated drug market doesn’t solve every problem associated with substance use, but it does solve this particular problem where there is a drug contaminating the drug supply. We don’t see that in the area of prescription medicines because that is a regulated market.”

The same argument was made by Jane Buxton, harm-reduction lead for the B.C. Centre for Disease Control (BCCDC).

“Because it’s an unregulated market, people don’t know what the substance is in the drug they are taking,” she said. “If we had a regulated market, we would know what was in the drugs.”

None of the interviewees favoured full legalization of hard drugs, but rather a nuanced version of decriminalization that would involve heavy regulation. Buxton named Portugal as a working example, while Kendall pointed to New Zealand.

A July 12 BCCDC bulletin stated that a provincewide study found 29 percent of participants tested positive for fentanyl, and of those drug users, 73 percent said they did not consume fentanyl knowingly. It noted that the portion of B.C. overdose deaths tied to fentanyl jumped from five percent in 2012 to 25 percent in 2014.

On specific measures, Montague said the VPD is also open to less traditional policies that could help prevent deaths linked to fentanyl. For example, he said, police would not oppose drug-testing sites like those deployed at some music festivals.

“We’re not naive,” Montague explained. “The police can stand here forever until we’re blue in the face and tell people not to use drugs, but we know people will use drugs.…So if people are going to use drugs, we would much rather have them use them safely than die as a result of an overdose.”

He stressed, however, that he has concerns about the limitations that drug testing can involve.

Lysyshyn noted that the Downtown Eastside has struggled with an influx of fentanyl for several years. He recalled one particularly challenging weekend, in October 2014, when Vancouver’s supervised-injection facility, Insite, recorded dozens of overdoses that were later linked to fentanyl. Lysyshyn emphasized that not one of those incidents ended in a death.

“People who live in the Downtown Eastside, even though that is the neighbourhood where you see the most overdoses, we are not seeing the most deaths there,” he said.

Lysyshyn pointed to data from Insite and B.C.’s take-home naloxone (a drug used to counter opioid overdoses) program that proves such harm-reduction initiatives save lives. With those initiatives deemed a success in the Downtown Eastside, Lysyshyn suggested there’s no reason variations wouldn’t work in other communities around the Lower Mainland.

Comments

24 Comments

Well...

Aug 5, 2015 at 12:26pm

Drug prohibition is organized crime that results in violence in the community (all of those "targeted attacks") and preventable death due to overdose and adulteration.

The "less traditional policy" that we need is head shops that do their own testing with a gas chromatograph. These things are not that expensive; a shop selling ecstasy could probably pay for one after a month. Now that Vancouver has entered into the regulation of marijuana, there is little excuse for not regulating other drugs.

Governments have a fiduciary duty to protect the welfare of their citizens. They're clearly not meeting that obligation; exactly where do they get their power of governing us from? Government should be a net-benefit, not a burden that creates violence and death.

Isaac Sobol

Aug 5, 2015 at 4:06pm

Public health physicians, and perhaps the majority of Canadians, recognize that the ongoing prohibition of "illicit" drugs have led to overdose deaths, organized crime profits, and have done little or nothing to reduce the use of such drugs. It is time to recognize the failure of our current drug laws and move to decriminalization and properly monitored regulations to protect individuals and neighborhoods, and increase respect for the law.

@Denise

Aug 6, 2015 at 10:33am

The moral failure argument concerning drug users is as offensive as suggesting that homosexuals would be straight if only society didn't push them to be gay. People use drugs because it is a part of their lifestyle, whether chosen or simply biologically predetermined.

There's prob. more evidence people are born to be drug users than born to be sober...

Bruce

Aug 6, 2015 at 11:33am

@@Denise

People are more likely to use drugs if their social environment is poor, and they're under stress (rich or poor). It does vary with circumstance, it isn't really comparable to homosexuality. Some people may be born more likely to become addicted, but environment does matter.

And those parents can be judged, drug using or not they engaged in it in a high risk way. A parent owning a motorbike has a lifestyle with some risk, but both parents on the same bike with no helmets is a whole other category of stupid.

Beatnuck

Brucifer

Aug 6, 2015 at 1:51pm

Why is this problem even happening? At age 12 in 1970 it was evident that Canadians are misled, misinformed and blatantly lied to, Continuously. Hard to feel proud as a Vimy Ridge beneficiary. Leadership VaaaaaCuuuuum!

@Bruce

Aug 6, 2015 at 2:26pm

That is the incomplete picture we have now because the mature, responsible drug users are in the closet. It is as though we got our picture of what the homosexual community is like based solely on who is showing up at the VD clinic...